Transportation and Health Equity Series, Part III

In this third installment, guest author Sara Schooley finishes laying the groundwork for understanding our nation's public health problems in relation to equity.

So we’ve established that the United States is in a bit of a kerfuffle when it comes to obesity. But the kerfuffle gets kerfuffle-ier.  There are huge differences in obesity rates between races.  Check out the maps below to see what I’m talking about.

For starters, look at Oregon.  For white Oregonians, 20-24% are categorized as obese (see side note) the CDC categorizes obese as a Body Mass Index >30.  So for example, I am 5’8” and to get a BMI ≥30, I would have to weigh 196lbs.  (You can calculate your own BMI here).  For Black, non-Hispanic Oregonians, over 35% are obese.  And looking at the differences in the maps, Oregon is not alone on this one.

Here’s where health equity comes in.  Health Equity has been defined as “…differences in health that are not only unnecessary and avoidable, but in addition unfair and unjust (Whitehead, 1992).”

So to bring it back to the maps, if you are born white in Oregon, you have a 20-25% chance of being obese and suffering from related health issues.  If you are born Black, you have over a 35% chance.  That seems definitely unnecessary, probably avoidable, and 100% unfair and unjust.

Let’s take a step back with the reasons for obesity.  If you’ve read any magazines/newspapers or watched any television you have probably heard the following mantra – a smart diet and exercise reduce your chances of obesity.  Simple enough and few people would say that a sensible diet and exercise is a bad idea.  I’m sure that most folks that are obese or overweight know this.  So then what’s the issue and why are there discrepancies between races?

We’ll get to the answer to this question in the next post. Until then, if you’d like to test your existing health equity statistics knowledge, maybe learn some shocking facts, and get some physical activity via finger clicking (pathetic, I know) take this little quiz on health equity.   

Next: What does transportation have to do with health equity?

Read the other parts of the series:

Transportation and Health Equity Part 1

Part II: Heath and Equity: What's the problem? 

Part IV: What makes us healthy?

Part V: Can transportation make you live longer?

Part VI: Your Neighborhood and Your Health

Part VII: Opportunities to Impact Health Equity

A big boon to people in Beaverton who bike to the MAX (and to those who are considering it): TriMet began construction today on a covered bike facility that will provide secure parking for 74 bicycles at the Beaverton Transit Center. An additional 26 covered spaces will also be available outside the cage.

The bike cage will provide access to the card-entry bike parking facility for a nominal fee (five cents per hour).

It should also persuade some reluctant to leave their high-end bicycles unattended to begin riding to the MAX and allow some currently bring their bikes onto the MAX with another option.

According to TriMet, 12% of Beaverton Transit Center riders already arrive by bike. The existing bike racks are full during the summer months. TriMet currently operates a similar structure at the Sunset Transit Center.

Saris Cycling Group is hosting a Poster Contest for fifth grade students. This is the perfect time to teach fifth grade students about the important role bicycle play in our environment, our community and our world.

Check out the contest rules and an easy checklist to use to ensure all entries are considered. Each school must select one poster to submit for this contest and these are due April 22nd, please send your artwork to Oregon Walk + Bike to School Committee, c/o 449 C Avenue, Lake Oswego, OR 97034.

And check out the awesome prizes for Oregon:

First Place
Schwinn Ranger Boys or Girls Mountain Bike
Lazer Helmet
Planet Bike Spok Light
Saris Bike Parking Rack for the School

Second Place
Lazer Helmet
Planet Bike Spok Light

Third Place
Lazer Helmet

We are always excited to see businesses find creative solutions to parking problems.  Any increase in access to a businesses means customers, clients, and employees will have more opportunities and options for getting to the location.  In October, we featured several businesses that were stepping up their bike parking access.

I stopped by the Owls Nest North space in Northeast Portland to take a look at this practical, yet charming solution to a potential problem.  Owls Nest is a collection of therapists working out of a residential area in Northeast Portland.  While many of their clients arrive by bicycle there is no place for the City of Portland to install one of our bicycle racks.  

Instead of force clients to lock up to a sign post (which is not very secure) or look for a bike rack elsewhere, the folks at Owls Nest North built their own rack out of recycled parts.  It's anchored in the yard, so it's secure.  What I appreciate most is that the rack's functionality  and funkiness blend beautifully into the little yard space.  You wouldn't even know it's a bicycle rack until you need it!

Have you noticed other creative solutions to parking or access issues of any kind?  Anybody know of a business that has "adopted" a bus stop or done something interesting with their auto parking lot?  Keep me posted!

Transportation and Health Equity series, Part IV

I’d like you to meet three of my fictional Portland friends (*note* all these people are fictional and the photos are from Microsoft PowerPoint):

Aaron: Aaron has lived in Portland his entire life except for his stint as a SeaBee in the Navy where he lived in Norfolk, Virginia.  Aaron moved back to Portland in order to marry his high school sweetheart and be closer to his family.  He works for a construction company, so has been wavering between employment and unemployment given the current economy.  He and his wife are proud parents of their 2-year old daughter, Dahlia.  Aaron is African-American.

Julie:  Julie is originally from Minnesota (like seemingly half of Portland) and moved to Portland after getting her degree in Economics at Carelton College.  Once in Portland, Julie landed an internship in Stumptown Coffee Co.’s marketing department.  Julie is Caucasian.

Mateo:  Mateo grew up in Troutdale and moved to Portland to attend the Art Institute of Portland.  He currently classifies himself as a ‘freelance photographer.’  Mateo is an avid soccer fan and is especially excited for the Timbers’ 2011 season to begin. Mateo is of Bolivian decent.

Each of my faux friends has different life experiences, many of which directly or indirectly influence their health.  Of course, there are personal lifestyle choices that affect Aaron, Julie and Mateo’s health - what they eat and how they do or do not exercise. 

But there are other components of health that often don’t fit into ‘health’ discussions and have been shown to be HUGELY important to one’s health, influence the diet/exercise combination, and some believe are more important than health care:

Employment. Unstable employment, and therefore, unpredictable income effects how and what people consume (food, shelter, etc.) in addition to adding to stress and loss of empowerment which is correlated with poorer health.

Education. Education is the most important indicator of life span and health during old age.  In Mississippi, almost 75% of adults who hadn’t completed high school reported being in less than very good health, compared with 37% of college graduates. In Vermont, which statistically is a ‘healthier’ state, 68% of adults who hadn't finished high school said they were in less than very good health, compared with 22% of college graduates. 

Seems convincing…this is a good motivation to learn Algebra II.  Have some fun messing with our education levels and, therefore, our health at http://www.commissiononhealth.org/Calculator.aspx.

Race. I’m going to parade this elephant right out of this room.  Whether or not we like it, race is a predictor of health indicators for a variety of factors that have yet to be flushed out completely in the health world but include historical racism in social and political forums. Did you know that the infant mortality rate and death from diabetes-related causes are DOUBLED in the African American population versus White or Hispanic?  Straight up scary and seriously in need of fixing.

So given where Aaron, Julie and Mateo fall on matters of employment, education, and race, I’ve put together some ‘average’ statistics:

I have to say, it doesn’t look good for Aaron. Mateo looks like he has an uphill battle.  And even Julie, who’s doing the best, in terms of ‘things that impact health’ has a 16.4% chance of being obese.  These three folks are perfect models for showing the struggle of Health Equity.  But how can the Portland Bureau of Transportation and other planning organization contribute to the he

alth of Aaron, Julie, and Mateo?  Before spilling the beans, I’m interested in what you, the loyal blog readers, are thinking.  Click the comment link and let me know what you think!